| NPI | 1902918188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09916) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107058) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-07-09 |